Stephen Lamarr Scoville, APRN
Nurse Practitioner, Family in Salt Lake City, UT. Individual provider (NPI-1).
NPI number1730516220
StatusActive
Last updated in NPPESApr 7, 2020
Details
- NPI
- 1730516220
- Entity type
- Individual (NPI-1)
- Name
- Stephen Lamarr Scoville
- Credential
- APRN
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 30, 2013
- Certification date
- Apr 7, 2020
- Last updated
- Apr 7, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | 7427208-4405 | UT | Yes |
Practice location
5788 S Waterbury WayUnit B
Salt Lake City, UT 84121-1141
Phone 801-662-9098
Mailing address
1115 S 900 ESalt Lake City, UT 84105-1323
Phone 801-662-9098
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